News / Oversight scheme change confirmed

NHS Improvement introduced a number of changes to the single oversight framework in advance of this month’s launch.

Following a consultation over the summer, it decided to introduce a metric on agency staff spending in full from 1 October, rather than in shadow form as previously planned.

The metric will assess distance from the agency spending cap, initially introduced last year. There are other changes to the finance and use of resources score outlined in its consultation. The oversight body also decided not to use EBITDA (earnings before interest, tax, depreciation and amortisation) margin, but to retain income and expenditure margin in line with existing frameworks.

The planned shadow metrics on cost per weighted activity unit and capital controls will also be assessed ahead of possible introduction next year.

If a trust has not agreed a control total and is planning for deficit, it can score no higher than 3 (where 1 is the best score and 4 the worst). Those planning a surplus without an agreed control total can score no more than 2 for use of resources.

NHS Improvement has also removed six planned quality metrics.

The single oversight framework will replace the Monitor risk assessment framework and the NHS Trust Development Authority accountability framework. Assessment will take place across five areas – finance, quality of care, operational performance, strategic change and leadership and improvement capability.

NHS Providers head of policy Miriam Deakin (pictured above) was pleased NHS Improvement had taken account of feedback from the service. But she added: ‘It isn’t possible to separate the introduction of the single oversight framework from the context in which providers and their partners are operating. ‘While the framework better co-ordinates NHS Improvement and the Care Quality Commission’s regulatory regimes, trusts are facing increased financial and operational pressure alongside a greater sense of “grip” from the national bodies. Improved clarity and less regulatory duplication are welcome in these challenging times, but providers would still like to see the national bodies take further strides to integrate and align their approaches.’